Understanding the dynamics of HIV testing services in South African primary care facilities

The gap in HIV testing remains significant and new modalities such as HIV self-testing (HIVST) have been recommended to reach key and under-tested populations. In December 2016, the World Health Organization (WHO) released the Guidelines on HIV Self-Testing and Partner Notification: A Supplement to the Consolidated Guidelines on HIV Testing Services (HTS) and urged member countries to develop HIVST policy and regulatory frameworks. In South Africa, HIVST was included as a supplementary strategy in the National HIV Testing Services Policy in 2016, and recently, guidelines for HIVST were included in the South African National Strategic Plan for HIV, sexually transmitted infections and tuberculosis 2017–2022. This document serves as an additional guidance for the National HIV Testing Services Policy 2016, with specific focus on HIVST. It is intended for policy advocates, clinical and non-clinical HTS providers, health facility managers and healthcare providers in private and public health facilities, non-governmental, community-based and faith-based organisations involved in HTS and outreach, device manufacturers, workplace programmes and institutes of higher education.

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Barriers to Effective HIV Testing Services and Strategies for Its Promotion at the Primary Health Care Facilities in Ibadan, Nigeria

International STD Research & Reviews ◽

10.9734/isrr/2020/v9i230111 ◽

2020 ◽

pp. 24-32

Author(s):

Christiana A. Oluwamotemi ◽

Funmilayo A. Okanlawon ◽

Elizabeth R. Edoni ◽

Ademola L. Adelekan

Keyword(s):

Health Care ◽

Primary Health Care ◽

Hiv Testing ◽

Health Care Providers ◽

Health Care Facilities ◽

Care Providers ◽

Primary Health ◽

Care Facilities ◽

Hiv Testing Services ◽

Primary Health Care Facilities

Background: HIV testing services (HTS) act as a critical entry point to HIV care, treatment and prevention services, and offer the opportunity for specially-trained health care providers to encourage avoidance of high risk sexual behaviour among both HIV negative and HIV-positive individuals. However, there are some challenges that can hinder effective delivery of HIV Counseling and Testing services by health care providers. This study was therefore designed to investigate barriers to effective HIV testing services and strategies for its promotion at the primary health care facilities in Ibadan. Methods: This descriptive cross-sectional study was carried out among health care providers in primary health care facilities in five local government areas in Ibadan metropolis, Nigeria. A 4-stage sampling techniques was used to select 19 respondents and interviewed using key informant interview guide. Interviews were transcribed verbatim. Spot check of transcripts were conducted to ensure completeness of the transcription. The data were sorted, categorized, and analyzed using a qualitative data analysis computer software package (NVivo). Results: All the respondents interviewed reported that, there were pre and post-tests counseling including HIV testing services in their facilities. Some respondents added there were laboratory services and linkages to other care and support services for those tested positive to HIV. However, most of the respondents reported insufficient consumables, insufficient staff, no privacy, lack of infrastructures as barriers to effective HIV testing services. Many of the respondents recommended community sensitization, more provision for consumables, drugs and kits as strategies for promoting HIV testing services. Conclusion: This study revealed that the primary health centres have pre-test and post-test HIV counseling services but insufficient consumables and staff were the major barriers to HIV testing services in this study. It is therefore necessary for government to make provision for consumables and more personnel to boost the activities of the health facilities.

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Utilization of HIV testing services among pregnant mothers in low income primary care settings in northern Ethiopia: a cross sectional study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-017-1389-2 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 7

Author(s):

Yihun Mulugeta Alemu ◽

Fentie Ambaw ◽

Annelies Wilder-Smith

Keyword(s):

Primary Care ◽

Hiv Testing ◽

Low Income ◽

Cross Sectional Study ◽

Northern Ethiopia ◽

Sectional Study ◽

Cross Sectional ◽

Primary Care Settings ◽

Hiv Testing Services ◽

Pregnant Mothers

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Suicidal Behavior in Black South Africans

Crisis ◽

10.1027//0227-5910.24.1.24 ◽

2003 ◽

Vol 24 (1) ◽

pp. 24-28 ◽

Cited By ~ 17

Author(s):

Lourens Schlebusch ◽

Naseema B.M. Vawda ◽

Brenda A. Bosch

Keyword(s):

South African ◽

Suicidal Behavior ◽

Health Care Facilities ◽

South African Society ◽

South Africans ◽

The Past ◽

The People ◽

Care Facilities ◽

Black South Africans ◽

To Come

Summary: In the past suicidal behavior among Black South Africans has been largely underresearched. Earlier studies among the other main ethnic groups in the country showed suicidal behavior in those groups to be a serious problem. This article briefly reviews some of the more recent research on suicidal behavior in Black South Africans. The results indicate an apparent increase in suicidal behavior in this group. Several explanations are offered for the change in suicidal behavior in the reported clinical populations. This includes past difficulties for all South Africans to access health care facilities in the Apartheid (legal racial separation) era, and present difficulties of post-Apartheid transformation the South African society is undergoing, as the people struggle to come to terms with the deleterious effects of the former South African racial policies, related socio-cultural, socio-economic, and other pressures.

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What Drives Utilization of Primary Care Facilities in Vietnam?

10.1596/32186 ◽

2019 ◽

Author(s):

Lan TH Vu ◽

Sarah Bales ◽

Caryn Bredenkamp

Keyword(s):

Primary Care ◽

Care Facilities

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Routine HIV testing in primary care: Does targeted training work?

10.26226/morressier.58ef94dcd462b80290b50740 ◽

2017 ◽

Author(s):

Katrina Perez

Keyword(s):

Primary Care ◽

Hiv Testing ◽

Routine Hiv Testing

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Patient Choice of Health Care Providers in China: Primary Care Facilities versus Hospitals

Health Systems & Reform ◽

10.1080/23288604.2020.1846844 ◽

2020 ◽

Vol 6 (1) ◽

pp. e1846844

Author(s):

Anwen Zhang ◽

Zlatko Nikoloski ◽

Sarah Averi Albala ◽

Winnie Yip ◽

Jin Xu ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Health Care Providers ◽

Patient Choice ◽

Care Providers ◽

Care Facilities

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964. Opt-Out HIV- Hepatitis C (HCV) Testing at a Primary Care Resident Clinic in Columbia, SC: Who Gets Tested and Who Opts Out of Testing?

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1150 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S512-S512

Author(s):

Jodian Pinkney ◽

Divya Ahuja ◽

Caroline Derrick ◽

Martin Durkin

Keyword(s):

Primary Care ◽

Hiv Testing ◽

Demographic Variables ◽

Demographic Characteristics ◽

Categorical Variables ◽

Newly Diagnosed ◽

Opting Out ◽

Opt Out ◽

Primary Care Resident ◽

Hcv Testing

Abstract Background South Carolina (SC) remains one of the most heavily affected states for both HIV and HCV infections. Males account for the majority of cases. Implementation of universal opt-out testing has improved screening rates but not much has been published describing the characteristics of those who opt out of testing. This becomes important as 10-50% of patients have opted out in previous studies. Methods Between February and August 2019, we conducted a quality improvement (QI) project which implemented opt- out HIV-HCV testing at a single primary care resident clinic in SC with the primary aim of increasing screening rates for HIV-HCV by 50%. Secondary aims included describing the demographic characteristics of the opt-out population. Persons were considered eligible for testing if they were between the ages of 18-65 years for HIV and 18-74 years for HCV. This was prior to the USPSTF 2020 guidelines which recommend HCV screening for adults aged 18-79 years. A retrospective chart review was used to obtain screening rates, opt status and demographic data. Logistic regression and the firth model were used to determine linkages between categorical variables. We present 3-month data. Results 1253 patients were seen between May 1, 2019- July 31, 2019 (See Table 1). 985 (78%) were eligible for HIV testing. 482 (49%) were tested for HIV as a result of our QI project and all tests were negative. 212 (22%) of eligible patients opted out of HIV testing. Males were 1.59 times more likely to opt out (p=0.008). (see Table 2,3) Regarding HCV, 1136 (90.7%) were deemed eligible for testing. 503 (44%) were tested for HCV as a result of our QI project. 12 (2.4%) were HCV antibody positive with viremia. 11 (90%) of antibody positive with viremia cases were in the 1945-1965 birth cohort (see Table 4). 244 (21%) opted out of HCV testing. Males and persons without a genitourinary chief complaint were more likely to opt out (p=0.02). Table 1: Demographic characteristics of the population seen at the internal medicine resident clinic between May- July 2019 Table 2: Relationship between demographic variables and the odds of being tested for HIV or HCV within the last 12 months. Logistic Model. Table 3: Relationship between demographic variables and the odds of opting out of testing for HIV or HCV. Firth Model. Conclusion Although implementation of routine HIV-HCV opt-out testing led to increased screening rates for both HIV and HCV, roughly 1 in 5 eligible patients chose to opt out of testing. Males were more likely to opt out despite accounting for the majority of newly diagnosed HCV cases. Future studies investigating drivers for opting-out in the male population could improve testing and assist with early diagnosis. Table 4: Characteristics of patients newly diagnosed with HCV positive with viremia. Disclosures All Authors: No reported disclosures

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